Privacy and Non-Discrimination Notices
Temple University Hospital, Inc., Jeanes Hospital, and the American Oncologic Hospital, doing business as Fox Chase Cancer Center do not exclude participation in, and no one is denied the benefits of, the delivery of quality medical care on the basis of race, religious creed, sex, sexual orientation, gender identity, disability, age, ancestry, color, national origin, physical ability, or source of payment.
TEMPLE UNIVERSITY HEALTH SYSTEM, INC. (TUHS)
NOTICE OF PRIVACY PRACTICES REGARDING PROTECTED HEALTH INFORMATION
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GAIN ACCESS TO THE INFORMATION. PLEASE REVIEW IT CAREFULLY.
YOU WILL BE ASKED TO ACKNOWLEDGE THAT YOU RECEIVED OUR NOTICE OF PRIVACY PRACTICES
Effective August 1, 2013
THE TUHS PRIVACY PRACTICES APPLY TO:
- Any Health Care Professional who treats you and enters information into your medical record
All employees, staff and other personnel at:
- Temple University Hospital, Inc. including Episcopal and Northeastern Ambulatory Campuses
- Jeanes Hospital
- Temple Physicians, Inc.
- Temple Health System Transport Team, Inc.
- Lewis Katz School of Medicine at Temple University
- Temple University School of Dentistry
- Temple University School of Podiatry
- Temple University College of Allied Health Professions
- Fox Chase Cancer Center Medical Group, Inc.
- American Oncologic Hospital
- Institute for Cancer Research
TUHS PRACTICES REGARDING THE USE AND RELEASE OF MEDICAL INFORMATION:
TUHS understands that medical information about you and your health is personal and is committed to protecting your medical information. A record is created of the care and services you receive as a patient. This record is needed to provide you with quality care, document the provision of appropriate medical services, and seek reimbursement for those services. Our privacy practices apply to all of the records of your care generated, or utilized, by our Health Care Professionals to provide you with healthcare services.
The purpose of this notice is to inform you about the ways in which your protected health information may be used and disclosed. It also describes your rights and other obligations regarding the use and disclosure of your protected health information.
TUHS IS REOUIRED BY LAW TO:
- ensure that protected health information is kept private;
- provide you with this Notice of our legal duties and privacy practices with respect to your protected health information;
- notify you if we determined that the security of your Protected Health Information was compromised because of a Breach.
- follow the terms of the Notice that are currently in effect.
We reserve the right to change our privacy practices from time to time in accordance with law. The then current Notice will be provided at the time of service, and is available upon request, as well as prominently posted in a public area.
HOW TUHS MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
FOR TREATMENT - Your medical information may be used to provide you with appropriate treatment and services. The physicians, nurses, technicians, and other health care personnel involved in your care may have access to your medical records. In addition, other TUHS personnel may be required to know only certain facts concerning your medical treatment in order to provide appropriate care. For example, a physician treating a patient for a broken leg will need to know if the patient is diabetic, or the physician may need to inform the hospital dietitian about a patient’s diabetes to provide appropriate meals. Different departments within TUHS may also need to share personal medical information in order to coordinate care such as x-rays, lab work or prescriptions. Medical information may also be disclosed to arrange appropriate medical care after discharge.
FOR PAYMENT - Protected Health Information may also be disclosed so that the treatment and services received may be billed to an insurance company or other third party payor such as Medicare. For example, protected health information may be disclosed to the patient’s insurance company in order to facilitate reimbursement. Some insurance companies require this disclosure prior to the initiation of treatment in order to determine the extent of coverage.
FOR HEALTH CARE OPERATIONS - Protected Health Information may be disclosed to ensure that TUHS is providing quality care. For example, medical information may be used to evaluate the performance of staff, or to educate staff. Doctors, nurses, technicians, medical students, and other TUHS personnel may utilize your medical information for educational purposes. In such situations, effort will be made to remove any information which may identify the patient.
FAMILY MEMBERS OR OTHER INDIVIDUALS INVOLVED IN CARE - Protected Health Information may be disclosed to family members or friends. Patients may limit or restrict the release of information to certain individuals. See the Right to Restrictions section of this Notice.
AS REQUIRED BY LAW - Protected Health Information may be disclosed as required by federal, state, or local law. This may include mandatory reporting to public health officials, the FDA and others.
ORGAN AND TISSUE DONATIONS - If you are an organ donor, medical information may be disclosed to organizations which are involved in organ procurement, as necessary, to facilitate organ or tissue donations and transplantations.
HEALTH RELATED BENEFITS AND SERVICES - TUHS may use and disclose medical information to inform you, or recommend possible treatment options or alternatives that may be of benefit to you, or remind you of appointments.
CORONERS, MEDICAL EXAMINERS AND FUNERAL DIRECTORS - Protected Health Information may be released to a coroner or medical examiner to, for example, determine a cause of death or identify a deceased person.
SENSITIVE INFORMATION - Federal and State laws requires additional protection for sensitive medical information in the following categories: drug and alcohol, mental health, HIV/AIDS and genetic testing. Generally, you will be asked for a written authorization before this type of information is released. However, there are limited circumstances under the law when this information may be released without your consent.
RESEARCH - A covered entity may use or disclose protected health information for research purposes pursuant to authorization by an Institutional Review Board (“IRB”). The IRB is an organizational committee that reviews and approves biomedical research that involves human subjects. Research that does not have approval for a consent waiver will require your written authorization before your Protected Health Information may be used.
FUNDRAISING - We may use and disclose your demographic information and the dates that you received treatment to contact you for fundraising activities supported by us. If we contact you for fundraising purposes, you will be provided with the opportunity to opt out of receiving any future solicitations.
OTHER USES OF PROTECTED HEALTH INFORMATION
Other uses of medical information not covered by this notice will only be made with your written permission. For example, most uses and disclosures of psychotherapy notes and of Protected Health Information for marketing purposes and the sale of Protected Health Information require an authorization. The most common reasons we would seek your authorization to use your health information would be for research purposes or to respond to media inquiries. This authorization may be revoked by you at any time.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION.
You have the following rights regarding medical information we maintain about you:
- Right to Inspect and Copy: You have the right to inspect and copy medical information that may be compiled while we are providing care. This does not apply to psychotherapy notes. Requests for the inspection or copying of medical records must be in writing to the Medical Records Department or your physician’s office. There will be an appropriate fee for copying. A request for review or copying will be responded to in most instances within 30 days, and may be denied in very limited circumstances. Such a decision shall be reviewed by the Facility Privacy Officer and, if appropriate, a licensed health care professional not associated with the original denial. An appeal of such a decision is available and may be requested by submitting a written request for appeal to the TUHS Corporate Compliance and Privacy Officer. You may reach the TUHS Corporate Compliance and Privacy Officer at (215) 707-5605.
Right to Amend: You have the right to request that any medical information, which is maintained by the facility, be amended if it is incorrect or incomplete. Such a request must be in writing and forwarded to the medical records department of the facility, which provided the service, or to your physician’s office. The request may be denied if the request is to amend information that:
- was not created by TUHS, unless the person or entity that created the information is no longer available to make the amendment;
- is not part of the medical information maintained by TUHS;
- is not part of the information which you would be permitted to inspect and copy; or
- is accurate and complete.
- Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures” which is a listing of disclosures made of your medical information. Such a request must be in writing to the Medical Records Department (Health Information Management) of the facility, which is providing the service, or to your physician’s office in the case of office records. The time frame cannot be longer than six years, and the first request within a 12-month period will be provided at no cost. Appropriate charges will be assessed for additional lists. We will respond to appropriate requests within 60 days.
- Right to Request Restrictions: You have the right to restrict the use of your medical information for the purpose of payment, treatment and operations. You may object to any other uses included in this notice, such as fundraising. You have the right to request restrictions on the medical information we disclose about you for the purpose of notification to relatives, or other persons identified by you as involved in your care. You also have the right to request restrictions on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a friend or family member. If admitted as an inpatient, you have the right to not be included in the hospital patient directory, which is used to direct calls and visits. Although we are not required to comply with such a request, we will attempt to do so. Such requests must be in writing to the medical records department of the TUHS facility, which is providing the service. Such requests must clarify what information is not to be released and to whom you wish the restriction to apply.
You have the right to restrict the release of information used for payment or health care operations that pertain to any health care item or service for which no insurance is utilized and you pay out of pocket. We are required to comply with such a request.
- Right to Request Confidential Communications: You have the right to request that we communicate with you about certain medical matters in a certain manner or at a particular address. For example, you might request that we only contact you at work or by mail. Such a request must be in writing and must be specific. All reasonable requests will be honored.
- Right to Notification of a Security Breach: You have the right to receive notification of a security breach as defined by the HIPAA Security rule. We will notify you in writing within 60 days of making a determination that a breach has occurred.
If you believe that your privacy rights have been violated, we encourage you to file a complaint with the facility Privacy Officer, or you may choose to direct your complaint to the Secretary of Health and Human Services.
You may also file a complaint regarding the Breach Notification process with the facility Privacy Officer or the Corporate Compliance and Privacy Officer. All complaints submitted in writing will be promptly investigated.
ANY QUESTIONS CONCERNING THIS NOTICE SHOULD BE DIRECTED TO THE TUHS PRIVACY OFFICER AS LISTED BELOW:
Temple University Hospital, Inc. including Episcopal and Northeastern Ambulatory Campuses
Temple Physicians, Inc.
Temple Health System Transport Team, Inc.
Temple University Physicians
Lewis Katz School of Medicine at Temple University
Temple University School of Dentistry
Temple University School of Podiatric Medicine
Temple University College of Allied Health Professions
Fox Chase Cancer Center Medical Group, Inc.
American Oncologic Hospital
Institute for Cancer Research